• Title/Summary/Keyword: glycated hemoglobin (HbA1c)

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A Study on the Hypoglycemic Effect and Safety of Combined-Therapy of Baekhogainsam-tang and Hypoglycemic Agent for Type 2 Diabetes Mellitus Patients without Complications: A Systematic Review and Meta-Analysis (합병증을 동반하지 않은 2형 당뇨병 환자에 대한 백호가인삼탕과 혈당강하제 병행치료의 혈당 강하 효과 및 안전성 연구 : 체계적 문헌 고찰과 메타분석)

  • Shin, Jae-ik;Baek, Ji-soo;Shin, Seon-mi;Cho, Chung-sik
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.672-686
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    • 2021
  • Objectives: The purpose of this study is to assess the efficacy and safety of Baekhogainsam-tang for type 2 diabetes without complications by systemic review and meta-analysis of randomized controlled trials (RCTs). Methods: For a systematic review and meta-analysis, we set a key question in accordance with PICOT-SD. We searched the following up to March 31. 2021: PubMed, EMBASE, The Cochrane Library, CNKI, CiNii, KISS, KMBASE, OASIS, and ScienceON. A meta-analysis was conducted by synthesizing the results, including fasting plasma glucose level, postprandial 2-hour plasma glucose level, and Glycated Hemoglobin (HbA1c). Results: A total of five trials are included in this systemic review. The treatment group (Baekhogainsam-tang plus conventional treatment) showed more statistically significant effect than did the control group (conventional treatment only) in fasting plasma glucose level, postprandial 2-hour plasma glucose level, and glycated hemoglobin (HbA1c). Conclusions: Baekhogainsam-tang showed statistically significant effects in hypoglycemic effect and in improving insulin resistance. However, the number of studies included in the meta-analysis was insufficient, and the BIT used in the included studies was not standardized. This topic requires further attention and more clinical research.

Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus

  • Yang, Yeoree;Lee, Eun-Young;Cho, Jae-Hyoung;Park, Yong-Moon;Ko, Seung-Hyun;Yoon, Kun-Ho;Kang, Moo-Il;Cha, Bong-Yun;Lee, Seung-Hwan
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.496-512
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    • 2018
  • Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

Effect of scaling and root planing combined with systemic doxycycline therapy on glycemic control in diabetes mellitus subjects with chronic generalized periodontitis: a clinical study

  • Gaikwad, Subodh P.;Gurav, Abhijit N.;Shete, Abhijeet R.;Desarda, Hitesh M.
    • Journal of Periodontal and Implant Science
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    • v.43 no.2
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    • pp.79-86
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    • 2013
  • Purpose: The purpose of study was to compare glycemic control using glycated hemoglobin levels ($HbA_{1c}$) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. Methods: Fifty subjects with type 2 diabetes mellitus ($T_2DM$) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and $HbA_{1c}$ level were recorded at baseline (day zero) and at the end of 4 months. Results: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. $HbA_{1c}$ values did not show a statistically significant difference in the treatment group as compared to the CG. Conclusions: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with $T_2DM$ in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.

A Case Report of Add-On Traditional Korean Medical Treatments in a Patient with Uncontrolled Type 2 Diabetes Mellitus with Conventional Oral Hypoglycemic Agents (기존의 경구용 혈당강하제로 혈당조절이 불량한 제2형 당뇨병 환자에 대한 한양방 병용 치료 1례)

  • Lee, Hye-Yoon;Jung, Eun-sun;Yun, Youngju;Lee, Sang Yeoup
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.718-726
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    • 2021
  • This study presents a case of add-on traditional Korean medical treatments in a 77-year-old male patient with uncontrolled type 2 diabetes mellitus with conventional oral hypoglycemic agents. Chief complaints were uncontrolled glucose level and weight loss. The patient was treated with electroacupuncture (on ST36, CV4, and CV12), herbal medication, and lifestyle advice. The conventional oral hypoglycemic medications were maintained. After 12 weeks, the glycated hemoglobin A1c (HbA1c) decreased from 11.0% to 8.4%. There were significant abnormalities in the liver function and renal function tests, but no adverse event was reported. Further studies are needed to confirm the findings of this case.

Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: a randomized controlled clinical trial

  • Telgi, Ravishankar Lingesha;Tandon, Vaibhav;Tangade, Pradeep Shankar;Tirth, Amit;Kumar, Sumit;Yadav, Vipul
    • Journal of Periodontal and Implant Science
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    • v.43 no.4
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    • pp.177-182
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    • 2013
  • Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c ($R^2$=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.

Anti-hyperglycemic Effect of Bangpungtongseong-san on Type II Diabetes Animal Models (제2형 당뇨 동물모델을 이용한 방풍통성산의 고혈당 개선효과)

  • Ko, Moon Hee;Cho, Hyun Woo;Nho, Jong Hyun
    • Korean Journal of Medicinal Crop Science
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    • v.28 no.4
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    • pp.287-297
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    • 2020
  • Background: Type II diabetes is considered as one of the common diseases. Bangpungtongseongsan (BPS) has been used as a traditional medicine for treating obesity and hypertension in Korea. According to previous reports, it has anti-obesity, anti-chronic asthma, anti-oxidant, and anti-inflammatory properties. However, the effects of BPS on type II diabetes have not yet been elucidated. Thus, in this sutudy, we evaluated the water extracts of BPS using type II diabetes animal models. Methods and Results: Each group was orally administered with BPS (170, 850 and 1,700 mg/kg) for approximately 13 weeks. A mixture of 150 mg/kg metformin and 10 mg/kg sitagliptin (MS) was used as a positive control. The glycated hemoglobin (HbA1c) and glucose levels, and hematological parameters including blood urine nitrogen, creatinine, low density lipoprotein and total cholesterol, were measured using blood samples. Treatment with 170 mg/kg BPS decreased the HbA1c and glucose levels in blood without affecting the weights of the animals. However, threatment with 1,700 mg/kg BPS reduced the weights and fatty liver, and increased the blood glucose level in type II diabetes animal models Conclusions: These results indicate that a low dose of BPS for 13 weeks, which reduces HbA1c and blood glucose levels, could be used for the treatment of type II diabetes. However, further studies are required to elucidate how active ingredients of BPS influence HbA1c and glucose levels in blood.

Motor and Somato Sensory Evoked Potentials During Intraoperative Surveillance Testing in Patients with Diabetes

  • Lee, Kyuhyun;Kim, Jaekyung
    • International journal of advanced smart convergence
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    • v.9 no.1
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    • pp.37-46
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    • 2020
  • Cerebral vascular surgery can damage patients' motor and sensory nerves; therefore, neuromonitoring is performed intraoperatively. Patients with diabetes often have peripheral neuropathy and may be prone to nerve damage during surgery. This study aimed to identify factors that should be considered when diabetic patients undergo intraoperative neuromonitoring during brain vascular surgery and to present new criteria. Methods: In patients with and without diabetes who underwent cerebrovascular surgery (n = 30/group), we compared the intraoperative stimulation intensity, postoperative motor power and sensory, glycated hemoglobin (HbA1c) and glucose levels, and imaging findings. Results: Fasting glucose, blood glucose, and HbA1c levels were 10%, 12.1%, and 9.7%, respectively; they were higher in patients with than in patients without diabetes. Two patients with diabetes had weakness, and 10 required increased Somato sensory evoked potential (SSEP) stimulation, while in 16, motor power recovered over time rather than immediately. The non-diabetic group had no weakness after surgery, but 10 patients required more increased SSEP stimulation. The diabetic group showed significantly more abnormal test results than the non-diabetic group. Conclusion: For patients with diabetes undergoing surgery with intraoperative neuromonitoring, whether diabetic peripheral neuropathy is present, their blood glucose level and the anesthetic used should be considered.

Effects of Korean Food-based Dietary Inflammatory Index Potential on the incidence of diabetes and HbA1c level in Korean adults aged 40 years and older (40세 이상 성인 한국인에서 한국형 식사염증지표 수준에 따른 당뇨병 발생률 및 당화혈색소 수준 변화 연구)

  • Yoon, Hyun Seo;Shon, Jinyoung;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.263-277
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    • 2022
  • Purpose: The present study examined the associations of Korean Food-based Index of Dietary Inflammatory Potential (FBDI) scores with the prevalence of diabetes and hemoglobin A1c (HbA1c) level of diabetes patients in Korean adults. Methods: The Korean Genome and Epidemiology Study (KoGES) Health Examinee baseline data, collected between 2004 and 2013 and followed up between 2012 and 2016, were used in our study. A total 56,391 participants including diabetes (n = 5,733) and non-diabetes (n = 50,658) were analyzed. The subjects were classified into quartiles of FBDI scores using the semi-quantitative food-frequency questionnaire developed for KoGES. The prevalence rate of diabetes under FBDI scores was assessed by Cox proportional risk models and the severity of the diabetes was analyzed by multiple regression analysis. Results: There were 775 incident cases of diabetes after a mean follow-up of 3.97 years. There was no statistically significant association between FBDI scores and incidence of diabetes. Among diabetes patients at baseline, FBDI scores were related to the risk of progression of diabetes which was represented by greater than 9% HbA1c (Q1 vs. Q4; odds ratio, 1.562 [95% confidence intervals, 1.13-2.15]; p for trend = 0.007). The stratified analysis showed a stronger association in females, irregular exercise group, and higher body mass index group. Conclusion: These results suggest that a pro-inflammatory diet is not associated with the incidence of diabetes but is related to the HbA1c level of diabetes patients. Thus, further longitudinal studies with longer periods are required to determine a relationship between dietary inflammatory index and diabetes in Korea.

Treatment-Induced Neuropathy of Diabetes (타입 1형 당뇨 환자에서 급작스런 혈당조절에 의해 발생한 신경염)

  • Kim, Kee Hoon;Leem, Min Jeong;Yi, Tae Im;Kim, Joo Sup;Yoon, Seo Yeon
    • Clinical Pain
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    • v.19 no.1
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    • pp.32-35
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    • 2020
  • Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

A Case Study of Type-II Diabetes Mellitus: Two Patients with Taeumin's Dry-febrile Symptom (태음인(太陰人) 조열증(燥熱證)으로 진단된 2형 당뇨병 환자 치험(治驗) 2례)

  • Lee, Seung-un;Hwang, Joo-won;Lee, Won-chul
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.509-519
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    • 2017
  • Objectives: This study describes how two patients diagnosed with type-II diabetes mellitus were successfully treated using herbal medicine. Methods: The patients were given Yuldahanso-tang to reduce the effects of Taeumin's dry-febrile symptom. Results: Type-II diabetes mellitus symptoms experienced by patients with Taeumin's dry-febrile symptom included thirst, fatigue, weight loss, and numbness in the hands and feet. After administering Yuldahanso-tang, all numerical levels for blood sugar, glycated hemoglobin (HbA1c), glycosuria, and proteinuria recovered to within normal levels. Conclusions: Treatment of patients with Taeumin's dry-febrile symptom and type-II diabetes mellitus with Yuldahanso-tang was effective, and this new evidence supports the use of herbal medicine for treating such patients.